The Confusion Over the New Ebola Outbreak

The Ebola virus has emerged again in the Democratic Republic of Congo, and brought along two of its primary symptoms: confusion and misinformation.

Earlier this morning, the World Health Organization announced that on May 11, the Ministry of Health of the Democratic Republic of the Congo (DRC) notified WHO and partners of a case of Ebola, which had been confirmed by a national reference laboratory in Kinshasa. A small wave of early stories reported this news, but at some point, the facts seemed to change. The AFP said: “Ebola epidemic declared in northeast DR Congo, three dead: WHO.”

Here’s what happened: Since April 22, 2017, there have been nine suspected cases of hemorrhagic fever in the DRC. Three of those people have died, one of whom tested positive for Ebola Zaire—the most dangerous of the virus’s several species. Of the nine cases, five have been tested and only one has been confirmed for Ebola. (It is not clear whether the five tests included all three deaths.)

There’s clearly an outbreak, but the WHO has not declared an epidemic—a term that implies wider or more sudden spread. The confusion is a linguistic one: The French use the same word—épidémie—for both outbreaks and epidemics

In 2014, the largest Ebola outbreak in history spread from Guinea to Liberia, Sierra Leone, and other countries, infecting more than 28,000 people and killing 11,000 of them before it was finally stopped in 2016. No one wants to see history repeat itself, so these first hours and days are crucial.

Fortunately, this is not the DRC’s first run-in with Ebola. The country has experienced eight outbreaks since 1976, most recently in 2014. While the world was struggling to contain Ebola in West Africa, the DRC also experienced a separate outbreak in August—but one that was swiftly contained by November, with a total of 66 cases and 49 deaths.

“It’s good to know that it’s not the first and only outbreak that the DRC has had,” Christian Lindmeier, a WHO spokesperson, tells me. “The health system is pretty stable and set up for this. The United Nations mission there and UNICEF have declared their willingness to help. The WHO Regional Director for Africa—Dr. Matshidiso Rebecca Moeti—is already on her way.”

“The WHO Country Office in the DRC is working closely with all national and provincial authorities … to facilitate the deployment of protection and personal equipment in the field to strengthen epidemiological surveillance and very quickly control the outbreak,” says Allarangar Yokouidé, a WHO Representative in DRC, in a statement.

The cases have all occurred in the Likati-Aketi territory—a hard-to-access part of the northern Bas-Uélé province. Lindmeier says that health workers have already begun the process of contact-tracing—backtracking the movements of the suspected cases to see how they connect with each other and with other members of their communities. They’re also looking into how the affected communities treat their sick and bury their dead—practices that could affect the spread of Ebola.

Meanwhile, health agencies are in early discussions about whether to deploy the vaccine that recently proved its worth in clinical trials. A partnership between Gavi, the Vaccine Alliance, and Merck means that 300,000 doses of that vaccine are available if needed. “We stand ready to support the DRC Government in its fight against Ebola,” says Seth Berkley, CEO of Gavi in a statement. “The fact that this is a country that has experience dealing with Ebola should give us hope that we won’t see a pandemic on the scale of the 2014 outbreak that hit West Africa.”

“These are literally the first hours of the response,” adds Lindmeier.

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